NPI 1154616258

Dsm Optometry LLC

Organisation Optometrist Idaho Falls, ID

Practice location

Address: 2300 E 17th St, Idaho Falls, ID 83404-6504
Phone: (208) 525-8964
Fax: (208) 524-6562
Mailing address: 652 Mill Stream St, Rexburg, ID 83440-5385

Authorised official

Name: Damon Scott Mortensen
Title: Owner/Dr.
Phone: (208) 525-8964

Registered specialties

Optometrist Primary

Eye and Vision Services Providers Taxonomy 152W00000X Licence ODP-100185 (ID)

Other Optometrist providers in Idaho →

Registry record

NPI: 1154616258
Entity type: Organization
NPI issued: 16 Jun 2011
Record last updated: 16 Jun 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.